162820 08/20/2008 CITY OF CARMEL, INDIANA VENDOR: 00351351 Page 1 of 1
e 0 ONE CIVIC SQUARE JACOB- DIETZ, INC
CARMEL, INDIANA 46032 2708 E MICHIGAN ST CHECK AMOUNT: $1,140.65
o
INDIANAPOLIS IN 46201 CHECK NUMBER: 162820
CHECK DATE: 8/20/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 48455 1,140.65 OTHER CONT SERVICES i
JAcoB_DiETz, INC. Inv oi ce
F d P R O T E C T I ON S P E C I A L IS T S
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317- 631 -2304 Fax 317 631 -3117 7/7/2008 48455
Bill To: Ship To:
Carmel Fire Department
2 Civic Square
Cannel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
7/7/2008 Carmel Fire Departm...
Quantity Description Rate Amount
87 Fire Extinguisher annual inspection 2.50 217.50
7 5# ABC hydrotest 11.85 82.95
1 10# ABC 6 year maintenance 11.00 11.00
1 10# ABC recharge 18.25 18.25
5 20# ABC hydrotest 21.15 105.75
3 2 -1/2 Gallon Water hydrotest 15.15 45.45
6 Liter K test recharge 70.00
1 10# CO2 test recharge 22.50 22.50
6 Amerex stem 4.00 24.00
13 OR29 Neck o -ring 1.15 14.95
3 340036K Neck o -ring 1.90 5.70
6 OR27 Neck o -ring 1.15 6.90
3 Kidde pro -line stem 3.25 9.75
4 Amerex stem 4.00 16.00
2 Badger stem 4.50 9.00
i' 15 #'CO2`valve`with siphon tube and elliow 59:85' 59.85
5 Valve Stem for K 11.40 57.00
3 Air Valve for water ext 2.20 6.60
2 Badger Stem 4.55 9.10
Subtotal
Sales Tax (0.0
T
Page 1
J DJACOB-nETZ,
INC. Invoice
P R O T E C T I O N S P E C I A L I S T S
2708 East Michigan Street Date Invoice
Indianapolis, IN 46201
317- 631 -2304 Fax 317 631 -3117 7/7/2008 48455
Bill To: Ship To:
Carmel Fire Department
2 Civic Square
Carmel, IN 46032
P.O. No. Work Order Terms Due Date Rep Project
7/7/2008 Carmel Fire Departm...
Quantity Description Rate Amount
4 New 5# ABC Fire Extinguisher 41.30 165.20
4 New 5# ABC Fire Extinguisher w/ vehicle brkt 45.80 183.20
Subtotal. 1,140.65
Sales Tax (0.0 $0.00
Total $1,140.65
Page 2
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
48455 Fire Ext. Annual Insp. $1,140.65
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jacob Dietz
IN SUM OF
2708 East Michigan Street
Indianapolis, IN 46201
$1,140.65
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 48455 43 509.00 $1,140.65 1 hereby certify that the attached invoice(s) or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Y
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund